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Jennifer Swingle Fogt, Matthew Karres, Abigail Menner, Joseph T Barr; Symptoms associated with mid-day fogging when using a novel scleral lens filling solution. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6350.
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© ARVO (1962-2015); The Authors (2016-present)
Mid-day fogging is frequently associated with scleral lens wear, resulting in symptoms such as dryness, blurred or fluctuating vision, and discomfort, that often require wearers to remove, clean, refill and reapply the lenses. Mid-day fogging may result at least partially from sloughing of corneal epithelial cells, and trapping of this particulate under the lens. Reducing cell sloughing, perhaps by using a lens filling solution similar to that of human tears, should therefore reduce the extent of mid-day fogging. The purpose of this study was to compare the symptoms of mid-day fogging when scleral lens wearers used a filling solution with an ionic composition and pH similar to tears to symptoms when using their habitual sodium chloride filling solution.
Twenty-three scleral lens wearers who experienced fogging were enrolled in the study. Seven subjects repeated the study. At the first visit, subjects completed the Ocular Surface Disease Index (OSDI) and visual analog surveys (VAS) to evaluate symptoms related to the habitual filling solution. Lens care regimens were recorded and assessments of vision, ocular health, lens fit, and fogging were completed. Next, subjects filled the bowl of their habitual lenses with the test solution containing calcium, magnesium, potassium, chloride and sodium ions, and with a pH matching the ocular surface. Slit lamp exam after use of the solution and again 4 hours later revealed no adverse events. A supply of solution was dispensed to subjects for filling of their scleral lenses until a follow-up visit 5-9 days later, which was scheduled at the same time of day as the first visit. All lens and ocular health assessments and surveys were repeated at this follow up visit.
Comparison of the OSDI scores revealed a 7.4 unit improvement when using the test solution compared to the habitual solution (p=0.02). Repeatability was confirmed, as there was no difference when comparing the change in OSDI scores for the subjects who completed the study twice (p=0.41). Improvements in symptoms of VAS score for symptoms of blurry/fluctuating vision (p=0.001), dryness (p=0.001), and overall pain/ocular discomfort (p=0.03) occurred when utilizing the test solution compared to the habitual solution.
In these patients, utilizing a solution that matches the pH and composition of tears resulted in improvement in some symptoms associated with mid-day fogging.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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